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Nasopharyngeal Cancer

3 sections of the pharnx The nasopharynx is the upper part of the pharynx (throat) behind the nose. Nasopharyngeal cancer occurs when the cells of the nasopharynx become abnormal and start growing in an uncontrolled way. The majority of nasopharyngeal cancers are squamous cell carcinomas (squamous cells are the thin, flat cells in the lining of the nasopharynx), but there are a number of other different types.

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Latest Research Publications

Information Patients and the Public (7 links)

Information for Health Professionals / Researchers (7 links)

Latest Research Publications

This list of publications is regularly updated (Source: PubMed).

Li T, Sheng L, Chunyan C, et al.
The significance of diffusion tensor magnetic resonance imaging for patients with nasopharyngeal carcinoma and trigeminal nerve invasion.
Medicine (Baltimore). 2017; 96(6):e6072 [PubMed] Free Access to Full Article Related Publications
To investigate the significance of diffusion tensor imaging (DTI) for patients with nasopharyngeal carcinoma (NPC) and trigeminal nerve invasion.Fifty-two patients with NPC and unilateral infringement and 30 healthy controls were recruited for our study. Routine magnetic resonance imaging (MRI) and DTI were performed for all participants. Within-group and between-group comparisons of DTI metrics, including fractional anisotropy (FA) and the apparent diffusion coefficient (ADC) of the third (V3) branch of the bilateral trigeminal nerves of all participants, were carried out.The FA and ADC values on the affected sides of patients revealed a significant decrease and increase, respectively, when compared with those on the unaffected sides of patients and the healthy controls (P = 0.000 for all), whereas there were no significant differences in DTI metrics between both sides of healthy controls or between the unaffected sides of patients and the healthy controls (P = 0.930, 0.580, 0.095, and 0.360, respectively). The decreasing FA rate on the affected sides of patients correlated negatively with the increasing ADC rate (r = -0.675, P = 0.000).DTI can quantitatively evaluate microstructural abnormalities of the V3 branch of the trigeminal nerve in patients with NPC, which is important for the early detection of trigeminal nerve invasion to achieve a precise T classification, assess prognosis, and guide treatment.

Hung TM, Fan KH, Chen EY, et al.
An elective radiation dose of 46 Gy is feasible in nasopharyngeal carcinoma treated by intensity-modulated radiotherapy: A long-term follow-up result.
Medicine (Baltimore). 2017; 96(6):e6036 [PubMed] Free Access to Full Article Related Publications
The purpose of this study is to compare the treatment outcome of different radiation doses of elective neck irradiation (ENI) in nasopharyngeal carcinoma (NPC) patients treated with intensity-modulated radiotherapy (IMRT).In total, 504 patients with nondisseminated NPC who underwent magnetic resonance imaging before radical IMRT between 2000 and 2008 were retrospectively reviewed. The patients were classified into 2 groups based on the ENI dose: low ENI when the ENI dose was 46 Gy (n = 446) and high ENI when the ENI doses were 50 to 60 Gy (n = 58). All the patients in both the groups received a median dose of 72 Gy to the gross tumor and involved nodes. The fraction size was 2 Gy per fraction. Matching was performed between low ENI and high ENI in a 2:1 ratio, and the matching criteria were N-stage, T-stage, treatment modality, pathology classification, sex, and age.The median follow-up for all patients was 63.5 months. In all patients, the 5-year progression-free survival (PFS), local control (LC), regional control (RC), distant metastasis-free survival (DMFS), overall survival (OS), and cancer-specific survival (CSS) for low ENI and high ENI patients were 69.0% and 63.2% (P = 0.331), 89.0% and 83.9% (P = 0.235), 90.1% and 85.2% (P = 0.246), 86.8% and 76.6% (P = 0.056), 77.5% and 80.8% (P = 0.926), and 84.4% and 82.5% (P = 0.237), respectively. In the matched-pair analysis, the 5-year PFS, LC, RC, DMFS, OS, and CSS for matched low ENI and high ENI patients were 74.1% and 63.2% (P = 0.134), 92.0% and 83.9% (P = 0.152), 90.1% and 85.2% (P = 0.356), 86.2% and 76.6% (P = 0.125), 87.0% and 80.8% (P = 0.102), and 88.6% and 82.5% (P = 0.080), respectively. In the multivariable analysis for all patients, the ENI group was not a significant factor for PFS, LC, RC, DMFS, OS, and CSS.A low ENI dose of 46 Gy in 23 fractions is feasible in NPC patients treated with IMRT, and this concept should be validated in the prospective studies.

Wu WJ, Wang SH, Ling W, et al.
Morning breathing exercises prolong lifespan by improving hyperventilation in people living with respiratory cancer.
Medicine (Baltimore). 2017; 96(2):e5838 [PubMed] Free Access to Full Article Related Publications
Disturbance of oxygen-carbon dioxide homeostasis has an impact on cancer. Little is known about the effect of breath training on cancer patients. Here we report our 10-year experience with morning breathing exercises (MBE) in peer-support programs for cancer survivors.We performed a cohort study to investigate long-term surviving patients with lung cancer (LC) and nasopharyngeal cancer (NPC) who practiced MBE on a daily basis. End-tidal breath holding time (ETBHT) after MBE was measured to reflect improvement in alveolar O2 pressure and alveolar CO2 pressure capacity.Patients (female, 57) with a diagnosis of LC (90 patients) and NPC (32 patients) were included. Seventy-six of them were MBE trainees. Average survival years were higher in MBE trainees (9.8 ± 9.5) than nontrainees (3.3 ± 2.8). The 5-year survival rate was 56.6% for MBE trainees and 19.6% for nontrainees (RR = 5.371, 95% CI = 2.271-12.636, P < 0.001). Survival probability of the trainees further increased 17.9-fold for the 10-year survival rate. Compared with the nontrainees, the MBE trainees shows no significant differences in ETBHT (baseline, P = 0.795; 1-2 years, P = 0.301; 3-4 years, P = 0.059) at baseline and within the first 4 years. From the 5th year onwards, significant improvements were observed in ETBHT, aCO2%, PaCO2, and PaO2 (P = 0.028). In total, 18 trainees (40.9%) and 20 nontrainees (74.1%) developed new metastasis (RR = 0.315, 95% CI = 0.108-0.919, P = 0.031).MBE might benefit for the long-term survival in patients with LC and NPC due to improvement in hyperventilation.

Xu L, Fan S, Zhao J, et al.
Increased expression of Cks1 protein is associated with lymph node metastasis and poor prognosis in nasopharyngeal carcinoma.
Diagn Pathol. 2017; 12(1):2 [PubMed] Free Access to Full Article Related Publications
BACKGROUND: The Cks1 protein is an essential factor in regulating cell cycle by mediating the ubiquitination of CDK inhibitor p27(kip1). It has been reported that aberrant expression of Cks1 and p27(kip1) proteins was found in various tumors and related to initiation and progression of carcinomas. However, the potential roles which Cks1 and p27(KIP1) proteins play in NPC remain unclear. This study aims to examine the expression status of Cks1 and p27(kip1) and their possible prognostic significance in NPC.
METHODS: Paraffin-embedded specimens with NPC (n = 168) and non-tumor nasopharyngeal tissues (n = 49) were analyzed by IHC.
RESULTS: Expression of Cks1 increased in NPC tissues compared with non-tumor nasopharyngeal tissues (P < 0.05), whereas p27(kip1) protein frequently expressed in non-tumor nasopharyngeal tissues compared with NPC tissues (P < 0.05). There was a significant reverse correlation between Cks1 and p27(kip1) protein expression in NPC (r = -0.189, P < 0.05).In addition, Kaplan-Meier survival curve showed that there was a significant tendency of shorter overall survival (OS) in NPC patients with Cks1 positive expression compared to negative ones, especially in patients with lymph node metastasis (P < 0.001, respectively). But there was no significance between p27(kip1) expression and survival viability of NPC patients. Multivariate Cox regression analysis further identified increased expression of Cks1 was the independent poor prognostic factor for NPC (p = 0.13).
CONCLUSION: Our research found expression of Cks1 increased and was inverse to the expression of p27(KIP1). High expression of Cks1 was significantly associated with lymph node metastasis and survival status in NPC. In addition, the abnormally high level of Cks1 protein was proved to be an independent poor prognostic factor in NPC. These results may provide novel clue for NPC therapy method.

Sim EU, Chan SL, Ng KL, et al.
Human Ribosomal Proteins RPeL27, RPeL43, and RPeL41 Are Upregulated in Nasopharyngeal Carcinoma Cell Lines.
Dis Markers. 2016; 2016:5179594 [PubMed] Free Access to Full Article Related Publications
Apart from their canonical role in ribosome biogenesis, there is increasing evidence of ribosomal protein genes' involvement in various cancers. A previous study by us revealed significant differential expression of three ribosomal protein genes (RPeL27, RPeL41, and RPeL43) between cell lines derived from tumor and normal nasopharyngeal epithelium. However, the results therein were based on a semiquantitative assay, thus preliminary in nature. Herein, we provide findings of a deeper analysis of these three genes in the context to nasopharyngeal carcinoma (NPC) tumorigenesis. Their expression patterns were analyzed in a more quantitative manner at transcript level. Their protein expression levels were also investigated. We showed results that are contrary to previous report. Rather than downregulation, these genes were significantly overexpressed in NPC cell lines compared to normal control at both transcript and protein levels. Nevertheless, their association with NPC has been established. Immunoprecipitation pulldown assays indicate the plausible interaction of either RPeL27 or RPeL43 with POTEE/TUBA1A and ACTB/ACTBL2 complexes. In addition, RPeL43 is shown to bind with MRAS and EIF2S1 proteins in a NPC cell line (HK1). Our findings support RPeL27, RPeL41, and RPeL43 as potential markers of NPC and provide insights into the interaction targets of RPeL27 and RPeL43 proteins.

Dong Y, Wang M
Knockdown of TKTL1 additively complements cisplatin-induced cytotoxicity in nasopharyngeal carcinoma cells by regulating the levels of NADPH and ribose-5-phosphate.
Biomed Pharmacother. 2017; 85:672-678 [PubMed] Related Publications
BACKGROUND: Transketolase-like 1 (TKTL1) plays an important role in pentose phosphate pathway (PPP) branch, the main pathway generating nicotinamide adenine dinucleotide phosphate (NADPH) and nucleotides for DNA synthesis. TKTL1 is closely related to DNA damage and has a close relationship with incidence and progression of cancers. Cisplatin is the main chemotherapeutic drug by inducing DNA damage. Whether TKTL1 knockdown additively complements cisplatin-induced cytotoxicity in nasopharyngeal carcinoma cells, however, remains largely undefined.
METHODS: Lipofectamine 2000 was used to transfect si-TKTL1s with different sequences into the CNE2 and HONE1 cells. The mRNA and protein levels of TKTL1 were determined by qRT-PCR and western blot, respectively. MTT assay and flow cytometry were used to access the viability and apoptosis of CNE2 and HONE1 cells. The NADPH and ribose-5-phosphate levels in both CNE2 and HONE1 cells were determined by NADPH examination kit and HPCE analysis, respectively. The effect of TKTL1 knockdown and NADPH/ribose-5-phosphate supplement on DNA damage was assessed by using Comet assay.
RESULTS: TKTL1 knockdown significantly decreased TKTL1 level in CNE2 and HONE1 cells. A significant decrease in cell viability and an obvious increase in cell apoptosis rate were found in si-TKTL1+cisplatin group compared with si-TKTL1 group or si-control+cisplatin group. The levels of NADPH and ribose-5-phosphate in CNE1 and HONE1 cells were dramatically decreased in si-TKTL1 group compared with si-control group. TKTL1 knockdown additively complemented cisplatin-induced cytotoxicity, which was partly reversed by the supplements of NADPH and ribose-5-phosphate, including the increased survival rate, decreased apoptosis and DNA damage.
CONCLUSIONS: Knockdown of TKTL1 additively complements cisplatin-induced cytotoxicity in the nasopharyngeal carcinoma cells by inhibiting the levels of NADPH and ribose-5-phosphate, indicating that TKTL1 may be a promising target to improve the therapeutic effect combining with cisplatin for the patients with nasopharyngeal carcinoma.

Cui Y, Zhang C, Luo R, et al.
Noninvasive monitoring of early antiangiogenic therapy response in human nasopharyngeal carcinoma xenograft model using MRI with RGD-conjugated ultrasmall superparamagnetic iron oxide nanoparticles.
Int J Nanomedicine. 2016; 11:5671-5682 [PubMed] Free Access to Full Article Related Publications
PURPOSE: Arginine-glycine-aspartic acid (RGD)-based nanoprobes allow specific imaging of integrin αvβ3, a protein overexpressed during angiogenesis. Therefore, this study applied a novel RGD-coupled, polyacrylic acid (PAA)-coated ultrasmall superparamagnetic iron oxide (USPIO) (referred to as RGD-PAA-USPIO) in order to detect tumor angiogenesis and assess the early response to antiangiogenic treatment in human nasopharyngeal carcinoma (NPC) xenograft model by magnetic resonance imaging (MRI).
MATERIALS AND METHODS: The binding specificity of RGD-PAA-USPIO with human umbilical vein endothelial cells (HUVECs) was confirmed by Prussian blue staining and transmission electron microscopy in vitro. The tumor targeting of RGD-PAA-USPIO was evaluated in the NPC xenograft model. Later, mice bearing NPC underwent MRI at baseline and after 4 and 14 days of consecutive treatment with Endostar or phosphate-buffered saline (n=10 per group).
RESULTS: The specific uptake of the RGD-PAA-USPIO nanoparticles was mainly dependent on the interaction between RGD and integrin αvβ3 of HUVECs. The tumor targeting of RGD-PAA-USPIO was observed in the NPC xenograft model. Moreover, the T2 relaxation time of mice in the Endostar-treated group decreased significantly compared with those in the control group both on days 4 and 14, consistent with the immunofluorescence results of CD31 and CD61 (P<0.05).
CONCLUSION: This study demonstrated that the magnetic resonance molecular nanoprobes, RGD-PAA-USPIOs, allow noninvasive in vivo imaging of tumor angiogenesis and assessment of the early response to antiangiogenic treatment in NPC xenograft model, favoring its potential clinical translation.

Qi G, Chen J, Shi C, et al.
Cinnamic Acid (CINN) Induces Apoptosis and Proliferation in Human Nasopharyngeal Carcinoma Cells.
Cell Physiol Biochem. 2016; 40(3-4):589-596 [PubMed] Related Publications
BACKGROUND/AIMS: CINN is the main ingredient of the traditional Chinese medicine cinnamon. The purpose of the present study was to investigate the effects of CINN on the proliferation and apoptosis of NPC cells and to elucidate the underlying molecular mechanisms.
MATERIALS AND METHODS: CNE2 human NPC cells were treated with various CINN concentrations. The effects of CINN on the proliferation and apoptosis of CNE2 NPC cells were examined using the MTT assay and flow cytometric analysis. Additionally, western blotting was performed to analyze the expression of a number of cell cycle- and apoptosis-related proteins.
RESULTS: The proliferation of CNE2 cells was significantly inhibited after treatment with different CINN concentrations for various lengths of time. The inhibitory effect of CINN was concentration-and time-dependent. Flow cytometric analysis showed that 2 mmol/L CINN displayed a significant apoptosis-inducing effect. The western blot analysis results showed that KLF6, Fas-L, Bax, P53 and caspase-3 protein expression was drastically increased in the CNE2 cells after treatment with 2 mmol/L CINN, whereas Bcl-2 and cyclin D1 protein expression was markedly reduced.
CONCLUSION: CINN inhibits the proliferation and induces the apoptosis of CNE2 cells. Therefore, CINN possesses a potential anti-tumor effect.

Luo R, Li M, Yang Z, et al.
Nomogram for radiation-induced hypothyroidism prediction in nasopharyngeal carcinoma after treatment.
Br J Radiol. 2017; 90(1070):20160686 [PubMed] Related Publications
OBJECTIVE: The aim of this study was to develop a nomogram for radiation-induced hypothyroidism (RHT) prediction.
METHODS: We collected data from 164 patients with nasopharyngeal carcinoma (NPC) in our previous prospective study. Biochemical hypothyroidism was defined as a serum thyroid-stimulating hormone level greater than the normal value. We collected both clinical and dose-volume factors. A univariate Cox regression analysis was performed to identify RHT risk factors. Optimal predictors were selected according to the least absolute shrinkage and selection operator (LASSO). We then selected the Cox regression models that best balanced the prediction performance and practicability to build a nomogram for RHT prediction.
RESULTS: There were 38 (23.2%) patients who developed RHT, and the median follow-up was 24 months. The univariate Cox regression analysis indicated that gender, minimum dose, mean dose (Dmean) and V25-V60 [Vx (%), the percentage of thyroid volume receiving >x Gy] of the thyroid were significantly associated with RHT. The variables of gender, receiving chemotherapy or not (chemo), Dmean and V50 were selected using the LASSO analysis. A nomogram based on a three-variable (gender, chemo and V50) Cox regression model was constructed, and its concordance index was 0.72. Good accordance between prediction and observation was showed by calibration curves in the probability of RHT at 18, 24 and 30 months.
CONCLUSION: This study built a nomogram for RHT in NPC survivors by analyzing both clinical and dose-volume parameters using LASSO. Thus, the individual dose constraint could be achieved in a visual format. Advances in knowledge: This study used LASSO to more accurately address the multicollinear problem between variables. The resulting nomogram will help physicians predict RHT.

Chan JW, Parvathaneni U, Yom SS
Reducing radiation-related morbidity in the treatment of nasopharyngeal carcinoma.
Future Oncol. 2017; 13(5):425-431 [PubMed] Related Publications
While radiation therapy is the mainstay of treatment for nasopharyngeal carcinoma, the anatomic location of the nasopharynx in close proximity to radiation-sensitive organs such as the salivary glands, optic nerves and chiasm, cochlea, brainstem and temporal lobes presents a special challenge. Technological approaches to reducing the morbidity of nasopharyngeal cancer irradiation have been historically successful with the evolution from 2D techniques to increasingly conformal forms of radiation therapy. This report reviews normal tissue dose constraints and major considerations in target delineation for patients with nasopharyngeal cancer in the intensity-modulated radiation therapy era. Furthermore, this report discusses more contemporary approaches to toxicity reduction such as the judicious reduction or omission of radiation to low-risk regions and the potential role of particle beam therapy.

Wang H, Wu S, Huang S, et al.
Follistatin-like protein 1 contributes to dendritic cell and T-lymphocyte activation in nasopharyngeal carcinoma patients by altering nuclear factor κb and Jun N-terminal kinase expression.
Cell Biochem Funct. 2016; 34(8):554-562 [PubMed] Free Access to Full Article Related Publications
Follistatin-like protein 1 (FSTL1) is a newly characterized protein that can regulate the immune response in various ways. Dendritic cells (DCs) are central to immune regulation. In this study, we explored the impact of FSTL1 on DC activity in nasopharyngeal carcinoma (NPC) patients. The surface expression of CD40, CD86, and HLA-DR on DCs was analyzed and showed significantly elevated expression levels, indicating DC maturity. After FSTL1 was added to DCs collected from NPC patients (n = 50), controls (n = 47), and healthy donors (n = 10), interferon γ secretion and T-cell receptor expression in cytotoxic T lymphocytes were also investigated. In the experimental groups, the expression of the critical immune protein nuclear factor (NF)-κb was upregulated, whereas Jun N-terminal kinase (JNK) was downregulated. Our findings demonstrate that FSTL1 plays a critical role in immune regulation, enhancing the antigen presentation ability of DCs by up-regulating NF-κb expression and down-regulating JNK expression.

Simo R, Robinson M, Lei M, et al.
Nasopharyngeal carcinoma: United Kingdom National Multidisciplinary Guidelines.
J Laryngol Otol. 2016; 130(S2):S97-S103 [PubMed] Free Access to Full Article Related Publications
This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. Although much commoner in the eastern hemisphere, with an age-standardised incidence rate of 0.39 per 100 000 population, cancers of the nasopharynx form one of the rarer subsites in the head and neck.1 This paper provides recommendations on the work up and management of nasopharyngeal cancer based on the existing evidence base for this condition. Recommendations • Patients with nasopharyngeal carcinoma (NPC) should be assessed with rigid and fibre-optic nasendoscopy. (R) • Nasopharyngeal biopsies should be preferably carried out endoscopically. (R) • Multislice computed tomographic (CT) scan of head, neck and chest should be carried out in all patients and magnetic resonance imaging (MRI) where appropriate to optimise staging. (R) • Radiotherapy (RT) is the mainstay for the radical treatment for NPC. (R) • Concurrent chemoradiotherapy offers significant improvement in overall survival in stage III and IV diseases. (R) • Surgery should only be used to obtain tissue for diagnosis and to deal with otitis media with effusion. (R) • Radiation therapy is the treatment of choice for stage I and II disease. (R) • Intensity modulated radiation therapy techniques should be employed. (R) • Concurrent chemotherapy with radiation therapy is the treatment of choice for stage III and IV disease. (R) • Patients with NPC should be followed-up and assessed with rigid and/or fibre-optic nasendoscopy. (G) • Positron emission tomography-computed tomography (PET-CT), CT or MRI scan should be carried out at three months from completion of treatment to assess response. (R) • Multislice CT scan of head, neck and chest should be carried out in all patients and MRI scan whenever possible and specially in advanced cases with suspected recurrence. (R) • Surgery in form of nasopharyngectomy should be considered as a first line treatment of residual or recurrent disease at the primary site. (R) • Neck dissection remains the treatment of choice for residual or metastatic neck disease whenever possible. (R) • Re-irradiation should be considered as a second line of treatment in recurrent disease. (R).

Zhao W, Lei H, Zhu X, et al.
The clinical characteristics of secondary primary tumors in patients with nasopharyngeal carcinoma after intensity-modulated radiotherapy: A retrospective analysis.
Medicine (Baltimore). 2016; 95(45):e5364 [PubMed] Free Access to Full Article Related Publications
To investigate the clinical characteristics associated with the risk of developing secondary primary tumors (SPTs) in patients with nasopharyngeal carcinoma (NPC) who underwent intensity-modulated radiotherapy (IMRT).Data from 527 patients with biopsy-proven nonmetastatic NPC who were treated with IMRT between January 2007 and December 2011 were analyzed retrospectively. The cumulative incidence of SPTs after IMRT completion was estimated using the Kaplan-Meier method. Intergroup differences in the cumulative incidence were determined using the log-rank test. The Cox proportional hazards regression model was used to confirm the risk factors associated with IMRT-induced SPTs.The median follow-up duration was 45.5 months (range, 4-97 months). Of the 527 patients, 12 (2.3%) developed posttreatment SPTs (9 men, 3 women), 6 of which were located in the irradiation field. SPTs were mostly located in the upper aerodigestive tract (n = 7), head and neck (n = 6), lungs (n = 3), and tongue (n = 2). The 1-, 3-, and 5-year cumulative SPT risk rates were 0.4%, 1.4%, and 3.1%, respectively, and the mean annual growth in cumulative incidence was approximately 0.6%. The 1-, 3-, and 5-year cumulative in-field SPT risk rates were 0.4%, 0.8%, and 1.5%, respectively, and the mean annual growth in the in-field cumulative incidence was approximately 0.3%. Univariate and multivariate analysis revealed that sex, age, clinical stage, chemotherapy, and overall IMRT duration did not significantly affect SPT risk. However, the history of smoking was the independent risk factor associated with SPT.The 5-year SPT incidence among patients with NPC after IMRT is concordant with or lower than that in previous 2-dimensional radiotherapy studies study. Among patients with NPC who underwent IMRT, the upper aerodigestive tract was the most common SPT site, and lung cancer was the most common pathology. Smoking history, but not sex, age, clinical stage, chemotherapy, and overall IMRT duration is the independent risk factor associated with SPT. Additional large-scale studies with longer-term follow-ups are needed to determine risk factors associated with SPT development after IMRT.

Sahoo AK, Preetam C, Kumar R, Samal DK
Bilateral blindness following anterior nasal packing in a case of nasopharyngeal angiofibroma.
J Laryngol Otol. 2016; 130(11):1072-1073 [PubMed] Related Publications
BACKGROUND: Epistaxis is the most common ENT emergency encountered in the Emergency Department. Most cases can be managed by simple anterior nasal packing. This is usually a safe and very effective option in an emergency situation, requiring minimal expertise and infrastructure. This paper describes a rare instance of a serious complication following anterior nasal packing in a case of nasopharyngeal angiofibroma.
CASE REPORT: A 27-year-old man diagnosed with nasopharyngeal angiofibroma presented to the Emergency Department with bilateral epistaxis. The patient was stabilised and anterior nasal packing was performed, which controlled the bleeding. Three hours later, the patient developed complete blindness in both eyes. Aggressive medical management was initiated immediately, but failed to restore the patient's vision.
CONCLUSION: Anterior nasal packing is a simple and minimally invasive procedure practised regularly in an Emergency Department setting. However, it can occasionally lead to serious complications such as blindness. Thus, obtaining informed consent is essential to avoid medico-legal consequences in high-risk cases.

Micera R, Simoni N, Liguoro M, et al.
The key role of 18F-FDG PET/CT for correct diagnosis, staging, and treatment in a patient with simultaneous NPC and TB lymphadenitis: case report.
Tumori. 2016; 102(Suppl. 2) [PubMed] Related Publications
AIMS AND BACKGROUND: The coexistence of tuberculous lymphadenitis of the neck region and head and neck cancer is extremely rare. In this clinical situation, the use of positron emission and computed tomography using fluorine-18 fluorodeoxyglucose (18F-FDG PET/CT) may facilitate the differentiation between malignancy and tuberculosis.
CASE REPORT: We present a case of an Eastern European man with nasopharyngeal cancer and concurrent tuberculous lymphadenitis.
RESULTS AND CONCLUSION: The adequate and critical interpretation of pretreatment 18F-FDG PET/CT scan addressed the multidisciplinary team to the proper staging of disease and to the correct therapeutic approach.

Ren M, Wang Z, Gao G, et al.
Impact of X-linked inhibitor of apoptosis protein on survival of nasopharyngeal carcinoma patients following radiotherapy.
Tumour Biol. 2016; 37(9):11825-11833 [PubMed] Related Publications
This study aims to investigate CNE1 and CNE2 cell proliferation and apoptosis of nasopharyngeal cancer (NPC) and X-linked inhibitor of apoptosis protein (XIAP) expression in NPC patients after radiotherapy. Quantitative real-time quantitative polymerase chain reaction (qRT-PCR) and Western Blot detected XIAP and XIAP-associated factor1 (XAF1) messenger RNA (mRNA) and protein expression of CNE1 and CNE2 in NPC cells irradiated by γ-ray; MTT and flow cytometry assays detected CNE2 cells proliferation and apoptotic rate, respectively. With a retrospective analysis of 109 NPC patients in Xinxiang Central Hospital, immunohistochemistry (IHC) method detected XIAP expression, followed by a 5-year clinical analysis of the prognosis relevance after radiotherapy. In vitro, the inhibition and apoptotic rates of cells increased with the growth of radiation dose. qRT-PCR and Western blot detection declared that XIAP mRNA and protein expression increased, whereas XAF1 mRNA and protein expression decreased with the growth of radiation dose and exposure time. And XIAP mRNA and protein expression were negatively correlated with proliferation and apoptotic rates of the cells. In vivo, positive XIAP expression rate was negatively correlated with pathological tumor-node-metastasis (p-TNM) staging and tumor differentiation. Further, high XIAP expression, high p-TNM staging, and lower degree of differentiation were significantly correlated with the decrease of NPC patients' survival rate. Additionally, XIAP expression, p-TNM staging, and degrees of differentiation were independent risk factors for the survival of the NPC patients after radiotherapy. Increased XIAP expression and decreased XAF1 expression may be one reason for the apoptosis delays of CNE1 and CNE2 cells after irradiation, and the XIAP expression or the p-TNM staging and degree of differentiation are independent risk factors for NPC patients' survival after radiotherapy, providing a molecular rationale for radiotherapy and prognosis of NPC.

Lu Y, Li T, Wei G, et al.
The long non-coding RNA NEAT1 regulates epithelial to mesenchymal transition and radioresistance in through miR-204/ZEB1 axis in nasopharyngeal carcinoma.
Tumour Biol. 2016; 37(9):11733-11741 [PubMed] Related Publications
Long non-coding RNAs (lncRNAs) play a critical role in cancer progression, including in nasopharyngeal carcinoma (NPC). However, it is still poorly understood whether lncRNA regulates epithelial to mesenchymal transition (EMT) and radioresistance of NPC cells. We found that lncRNA NEAT1 was significantly upregulated in NPC cell lines and tissues. Knockdown of NEAT1 could sensitize NPC cells to radiation in vitro. Further investigation found that NEAT1 regulated radioresistance by modulating EMT phenotype. Furthermore, we found that there was reciprocal repression between NEAT1 and miR-204. ZEB1 was identified as a downstream target of miR-204 and NEAT1 upregulated ZEB1 expression by negatively regulating miR-204 expression. Taking together, we proposed that NEAT1 regulated EMT phenotype and radioresistance by modulating the miR-204/ZEB1 axis in NPC.

Mishra A, Singh V, Verma V, et al.
Current status and clinical association of beta-catenin with juvenile nasopharyngeal angiofibroma.
J Laryngol Otol. 2016; 130(10):907-913 [PubMed] Related Publications
OBJECTIVE: A possible role of the APC/beta-catenin pathway in the pathogenesis of sporadic juvenile nasopharyngeal angiofibroma has been suggested. This paper presents its current status and clinical association in our patients.
METHOD: A prospective observational study was conducted at King George Medical University and Central Drug Research Institute, in Lucknow, India. Western blot analysis was undertaken in 16 cases to examine beta-catenin expression. The clinical details were recorded along with follow up observations, to determine associations.
RESULTS: Up-regulation of beta-catenin expression was seen in 69 per cent of cases. The clinical variables did not reveal significant differences between patients with extremes of expression (extreme under- vs over-expression). However, absent expression was shown exclusively in young adults aged over 18 years, while enhanced expression was associated with an altered facial profile.
CONCLUSION: Although a beta-catenin association was seen in a subset of our sporadic juvenile nasopharyngeal angiofibroma cases, its expression was not homogeneous. This is in contrast to the Western literature that suggests a universal (homogenous) enhanced expression in the majority. Hence, further research is required to better define its molecular cascade.

Ai J, Li W, Zeng R, et al.
Blockage of SSRP1/Ets-1/Pim-3 signalling enhances chemosensitivity of nasopharyngeal carcinoma to docetaxel in vitro.
Biomed Pharmacother. 2016; 83:1022-1031 [PubMed] Related Publications
Nasopharyngeal carcinoma (NPC) is a rare cancer in most parts of the world, but is prevalent in South China area. Besides, therapeutic outcome is still unsatisfactory for patients with refractory and relapsed NPC, even though receiving a second line of docetaxel-based chemotherapy. These reasons require a better understanding of mechanisms underlying the carcinogenesis, malignancy and chemoresistance. In the basis of our previous finding of SSRP1 over-expression in NPC cell lines, this study continuously discovered up-regulated Ets-1, phosphor-Ets-1 and Pim-3 in NPC tissues with immunohistochemistry assay and revealed a close correlation of these up-regulated proteins with NPC proliferation and invasion. Using gene-silencing technology followed by western blot and immunocytochemistry detections, SSRP1 was found to facilitate the translocation of phosphor-Ets-1 from cytoplasm to cell nucleus, but have marginal effect on Ets-1 expression and phosphorylation. Pim-3 was positively regulated by Ets-1. In NPC HNE-1 cells, all SSRP1, Ets-1 and Pim-3 knockdown diminished the cell proliferation, enhanced the apoptosis, as well as inhibited the autophagy, invasion and clonogenicity in the presence or absence of docetaxel at IC25. Exposure of HNE-1 cells to docetaxel (IC25) alone had modest effect on cell proliferation and autophagy, and was not as effective as docetaxel treatment after knockdown of SSRP1, Ets-1 or Pim-3 on induction of the apoptosis and on inhibition of the invasion and clonogenicity. Our data indicate that SSRP1/Ets-1/Pim-3 signalling is tightly associated with the proliferation, apoptosis, autophagy, invasion and clonogenicity of NPC cells, and blockage of this signalling facilitates chemosensitivity of the cells to docetaxel.

Zhang L, Huang Y, Hong S, et al.
Gemcitabine plus cisplatin versus fluorouracil plus cisplatin in recurrent or metastatic nasopharyngeal carcinoma: a multicentre, randomised, open-label, phase 3 trial.
Lancet. 2016; 388(10054):1883-1892 [PubMed] Related Publications
BACKGROUND: Outcomes are poor for patients with recurrent or metastatic nasopharyngeal carcinoma and no well established first-line chemotherapy is available for the disease. We compared the efficacy and safety of gemcitabine plus cisplatin versus fluorouracil plus cisplatin in patients with recurrent or metastatic nasopharyngeal carcinoma.
METHODS: In this multicentre, randomised, open-label, phase 3 trial, patients with recurrent or metastatic nasopharyngeal carcinoma were recruited from 22 hospitals in China. Key inclusion criteria were Eastern Cooperative Oncology Group performance status of 0 or 1, adequate organ function, and measurable lesions according to Response Evaluation Criteria in Solid Tumors version 1.1. Patients were randomly assigned in a 1:1 ratio to receive either gemcitabine (1 g/m(2) intravenously on days 1 and 8) and cisplatin (80 mg/m(2) intravenously on day 1), or fluorouracil (4 g/m(2) in continuous intravenous infusion over 96 h) and cisplatin (80 mg/m(2) on day 1 given intravenously) once every 3 weeks for a maximum of six cycles. The randomisation was done centrally via an interactive phone response system using block randomisation with a size of six. The primary endpoint was progression-free survival assessed by the independent image committee in the intention-to-treat population. Safety analyses were done in patients who received at least one cycle of study drug. This study is ongoing and is registered with ClinicalTrials.gov, number NCT01528618.
FINDINGS: Between Feb 20, 2012, and Oct 30, 2015, 362 patients were randomly assigned to a group (181 to the gemcitabine [plus cisplatin] group and 181 to the fluorouracil [plus cisplatin] group). Median follow-up time for progression-free survival was 19·4 months (IQR 12·1-35·6). The median progression-free survival was 7·0 months (4·4-10·9) in the gemcitabine group and 5·6 months (3·0-7·0) in the fluorouracil group (hazard ratio [HR] 0·55 [95% CI 0·44-0·68]; p<0·0001). A total of 180 patients in the gemcitabine group and 173 patients in the fluorouracil group were included in the safety analysis. Significantly different treatment-related grade 3 or 4 adverse events between the gemcitabine and fluorouracil groups were leucopenia (52 [29%] vs 15 [9%]; <0·0001), neutropenia (41 [23%] vs 23 [13%]; p=0·0251), thrombocytopenia (24 [13%] vs three [2%]; p=0·0007), and mucosal inflammation (0 vs 25 [14%]; <0·0001). Serious treatment-related adverse events occurred in seven (4%) patients in the gemcitabine group and ten (6%) in the fluorouracil group. Six (3%) patients in the gemcitabine group and 14 (8%) patients in the fluorouracil group discontinued treatment because of drug-related adverse events. No treatment-related deaths occurred in either group.
INTERPRETATION: Gemcitabine plus cisplatin prolongs progression-free survival in patients with recurrent or metastatic nasopharyngeal carcinoma. The results establish gemcitabine plus cisplatin as the standard first-line treatment option for this population.
FUNDING: Sun Yat-Sen University Clinical Research 5010 Programme, Chinese National Natural Science Foundation project (grant numbers 81372502 and 81201917), the National High Technology Research and Development Program of China (863 program numbers 2012AA02A501 and 2012AA02A502), and the Natural Science Foundation of Guangdong (grant number S2013010016564).

Zhang J, Shu C, Song Y, et al.
Epstein-Barr virus DNA level as a novel prognostic factor in nasopharyngeal carcinoma: A meta-analysis.
Medicine (Baltimore). 2016; 95(40):e5130 [PubMed] Free Access to Full Article Related Publications
BACKGROUND: The plasma Epstein-Barr virus (EBV) DNA level in patients with nasopharyngeal carcinoma (NPC) performs as an appealing prognostic factor, but conclusions of its prognostic values from previous studies are inconsistent. In this study, we performed a comprehensive meta-analysis to evaluate the prognostic value of EBV DNA level in patients with NPC.
METHODS: Published studies were searched in PubMed. The baseline characteristics of patients, overall survival (OS), and other survival outcomes were extracted. Pooled hazard ratio (HR), 95% confidence interval (CI), and P value were calculated to estimate the prognostic value of EBV DNA level. Each cut-off value mentioned in the studies was obtained. Kaplan-Meier curves were used to extract data, and graphical survival plots were extracted for calculating HR when the study did not describe the information directly.
RESULTS: This meta-analysis pooled 23 eligible studies including 10,732 patients with NPC. The pooled HR (95% CI) of pretreatment plasma EBV DNA level (pre-DNA) for OS was 2.78 (2.19, 3.55), and the HR (95% CI) of posttreatment plasma EBV DNA level (post-DNA) for OS was 5.43 (2.72, 10.82), suggesting that EBV DNA level was significantly correlated to the outcomes of patients with NPC.
CONCLUSION: High expression levels of EBV DNA predicts poor prognosis in NPC.

Wang C, Cheng Y, Liu H, et al.
Pectolinarigenin Suppresses the Tumor Growth in Nasopharyngeal Carcinoma.
Cell Physiol Biochem. 2016; 39(5):1795-1803 [PubMed] Related Publications
BACKGROUND/AIMS: Nasopharyngeal cancer (NPC) is one of the common human malignant diseases all over the world, and chemotherapy remains the main therapy for NPC. However, the survival and life quality of NPC patients are still very poor. Thus, novel and selective anti-tumor agents are pressingly needed. Our previous study identified pectolinarigenin as a novel effective anti-tumor drug candidate for NPC. In this study, we further investigated its anti-tumor activities and explored the potential molecular mechanism.
METHODS: NPC C666-1 cells were cultured and treated by pectolinarigenin. Cell proliferation assay, colony formation assay, Transwell assay and wound healing assay were conducted and cell apoptosis was detected by flow cytometry. Mitochondrial transmembrane potential and ROS were also observed. NPC subcutaneous xenograft mice model was established to evaluate the anti-tumor effect of pectolinarigenin in vivo.
RESULTS: We observed that treatment of pectolinarigenin inhibited cell viability and cell migration of NPC C666-1 cells in concentration- and time-dependent manner. Pectolinarigenin induced cell apoptosis in C666-1 cells detected by flow cytometry analysis, which was associated with the activation of mitochondrial-related apoptosis and the accumulation of reactive oxygen species (ROS). Pectolinarigenin also activated caspase signaling pathway. The in vivo experiment of subcutaneous xenograft mice model also indicated that the administration of pectolinarigenin could decrease the tumor growth of NPC and no severe toxicity was observed.
CONCLUSIONS: Based on our findings, we conclude that pectolinarigenin could suppress the tumor growth of NPC, which verifies it as a new therapeutic agent for treating this devastating disease.

Lin PC, He JY, Le YY, et al.
Radiation-Guided Peptide Delivery in a Mouse Model of Nasopharyngeal Carcinoma.
Biomed Res Int. 2016; 2016:5382047 [PubMed] Free Access to Full Article Related Publications
Purpose. This study aimed to evaluate the characteristics of the HVGGSSV peptide, exploring radiation-guided delivery in a mouse model of nasopharyngeal carcinoma. Methods. Mice with CNE-1 nasopharyngeal carcinoma were assigned to two different groups treated with Cy7-NHS and Cy7-HVGGSSV, respectively. Meanwhile, each mouse received a single dose of 3 Gy radiation. Biological distribution of the recombinant peptide was assessed on an in vivo small animal imaging system. Results. The experimental group showed maximum fluorescence intensity in irradiated tumors treated with Cy7-labeled HVGGSSV, while untreated (0 Gy) control tumors showed lower intensity levels. Fluorescence intensities of tumors in the right hind limbs of experimental animals were 7.84 × 10(7) ± 1.13 × 10(7), 1.35 × 10(8) ± 2.66 × 10(7), 4.05 × 10(8) ± 1.75 × 10(7), 5.57 × 10(8) ± 3.47 × 10(7), and 9.26 × 10(7) ± 1.73 × 10(7) photons/s/cm(2) higher compared with left hind limb values at 1, 2, 15, 24, and 48 h, respectively. Fluorescence intensities of tumor in the right hind limbs of the experimental group were 1.66 × 10(8) ± 1.71 × 10(7), 1.51 × 10(8) ± 3.23 × 10(7), 5.38 × 10(8) ± 1.96 × 10(7), 5.89 × 10(8) ± 3.57 × 10(7), and 1.62 × 10(8) ± 1.69 × 10(7) photons/s/cm(2) higher compared with control group values at 1, 2, 15, 24, and 48 h, respectively. Fluorescence was not specifically distributed in the control group. Compared with low fluorescence intensity in the heart, lungs, and tumors, high fluorescence distribution was found in the liver and kidney at 48 h. Conclusions. HVGGSSV was selectively bound to irradiated nasopharyngeal carcinoma, acting as a targeting transport carrier for radiation-guided drugs that are mainly metabolized in the kidney and liver.

Ai QY, King AD, Law BK, et al.
Diffusion-weighted imaging of nasopharyngeal carcinoma to predict distant metastases.
Eur Arch Otorhinolaryngol. 2017; 274(2):1045-1051 [PubMed] Related Publications
Our study aimed to identify diffusion-weighted imaging (DWI) parameters obtained from primary nasopharyngeal carcinoma (NPC) at initial presentation, that can predict patients at risk of distant metastases. One hundred and sixty-four patients underwent pretreatment magnetic resonance imaging and DWI. The apparent diffusion coefficient (ADC)mean, ADCskewness, and ADCkurtosis were obtained by histogram analysis. Univariate and multivariate analyses of these ADC parameters together with primary volume (PV), nodal volume (NV), T stage, N stage and presence of locoregional relapse (LRR) were compared between patients with distant metastases (DM+) and patients without distant metastases (DM-) at 5 years using logistic regression. Twenty-eight out of 164 patients (17.1 %) were DM+ (2.5-60 months) and 136/164 patients were DM- (61.2-119.4 months). Compared to DM- patients, the primary tumour of DM+ patients showed significantly lower ADCskewness (ADC values with the greatest frequency were higher) (p = 0.041), and higher PV (p = 0.022), NV (p < 0.01), T stage (p = 0.023), N stage (p < 0.01) and LRR (p < 0.01). On multivariate analysis the ADCskewness was no longer significant (p = 0.120) and only NV and LRR were independent predictors for DM+ (p = 0.023 and 0.021, respectively). DWI showed that compared to DM- patients, DM+ patients had a significantly lower primary tumour ADCskewness, but at initial presentation NV was the only independent predictor of DM.

Pang MJ, Yang Z, Zhang XL, et al.
Physcion, a naturally occurring anthraquinone derivative, induces apoptosis and autophagy in human nasopharyngeal carcinoma.
Acta Pharmacol Sin. 2016; 37(12):1623-1640 [PubMed] Free Access to Full Article Related Publications
AIM: Physcion is a major bioactive ingredient in the traditional Chinese medicine Radix et Rhizoma Rhei, which has an anthraquinone chemical structure and exhibits a variety of pharmacological activities including laxative, hepatoprotective, anti-inflammatory, anti-microbial and anti-proliferative effects. In this study we investigated the effect of physcion on human nasopharyngeal carcinoma in vitro and in vivo, as well as the mechanisms underlying the anti-tumor action.
METHODS: The nasopharyngeal carcinoma cell line CNE2 was treated with physcion, and cell viability was detected using MTT and colony formation assays. Flow cytometry was used to assess the cell cycle arrest, mitochondrial membrane potential loss, apoptosis, autophagy and intracellular ROS generation. Apoptotic cell death was also confirmed by a TUNEL assay. The expression of target or marker molecules was determined using Western blotting. The activity of caspase-3, 8, and 9 was detected with an ELISA kit. A xenograft murine model was used to evaluate the in vivo anti-tumor action of physcion, the mice were administered physcion (10, 20 mg·kg(-1)·d(-1), ip) for 30 d.
RESULTS: Treatment with physcion (5, 10, and 20 μmol/L) dose-dependently suppressed the cell viability and colony formation in CNE2 cells. Physcion (10 and 20 μmol/L) dose-dependently blocked cell cycle progression at G1 phase and induced both caspase-dependent apoptosis and autophagy in CNE2 cells. Furthermore, physcion treatment induced excessive ROS generation in CNE2 cells, and subsequently disrupted the miR-27a/ZBTB10 axis, resulting in repression of the transcription factor Sp1 that was involved in physcion-induced apoptosis and autophagy. Moreover, physcion-induced autophagy acted as a pro-apoptotic factor, and possibly contributed to physcion-induced apoptosis. In the xenograft murine model, administration of physcion dose-dependently suppressed the tumor growth without affecting the body weight. Furthermore, the anti-tumor effects of physcion were correlated with downregulation of Sp1 and suppression of miR-27a in the tumor tissues.
CONCLUSION: Physcion induces apoptosis and autophagy in human nasopharyngeal carcinoma by targeting Sp1, which was mediated by ROS/miR-27a/ZBTB10 signaling. The results suggest that physcion is a promising candidate for the treatment of human nasopharyngeal carcinoma.

Wu X, Huang J, Liu L, et al.
Cetuximab concurrent with IMRT versus cisplatin concurrent with IMRT in locally advanced nasopharyngeal carcinoma: A retrospective matched case-control study.
Medicine (Baltimore). 2016; 95(39):e4926 [PubMed] Free Access to Full Article Related Publications
To evaluate the treatment efficacies and toxicities of concurrent cetuximab-based bioradiotherapy (BRT) or cisplatin-based chemoradiotherapy (CRT) in locally advanced nasopharyngeal carcinoma. :Patients with previously untreated locally advanced nasopharyngeal carcinoma were matched into pairs, and enrolled into the study. All patients were given either BRT or CRT. Survival outcomes, toxicities, and prognostic factors were evaluated. :A total of 112 patients were enrolled. The 5-year overall survival was 79.3% and 79.5% in CRT and BRT arm, respectively (P = 0.797) and the 5-year DFS was 73.5% and 74.6%, respectively (P = 0.953). In toxicity analysis, CRT arm had more significant decrease in white blood cell, platelet, hemoglobin, and severe vomiting, while more severe skin reactions and mucositis were shown in BRT arm. :BRT was not less efficacious than traditional CRT. They lead to different aspects of toxicities. If patients cannot stand more severe toxicities caused by CRT, BRT could be an ideal alternative.

Bao L, Liu H, You B, et al.
Overexpression of IGFBP3 is associated with poor prognosis and tumor metastasis in nasopharyngeal carcinoma.
Tumour Biol. 2016; 37(11):15043-15052 [PubMed] Related Publications
Insulin-like growth factor-binding protein-3 (IGFBP3) is an N-linked glycosylated, phosphorylated protein, which has been reported to regulate cancer progression and metastasis. However, the role of IGFBP3 in tumor metastasis remains under debate. Nasopharyngeal carcinoma (NPC) is a highly metastatic head and neck cancer. And it fails to achieve the desired therapeutic efficacy in patients with metastasis, while the role of IGFBP3 in NPC is still unclear. In this study, we first used immunohistochemistry to explore the expression of IGFBP3 in NPC tissues. We found that IGFBP3 was significantly elevated in NPC and its expression level was correlated with N classification, distant metastasis, and TNM clinical stage (all P < 0.05). Patients with high expression of IGFBP3 had poorer survival rate (P < 0.05). In addition, we found that downregulation of IGFBP3 inhibited cell migration and adhesion by Transwell migration assay, wounding healing assay, and cell adhesion assays in vitro. Besides, NPC cells stimulated with recombinant IGFBP3 accelerated migration and adhesion. These data suggest overexpression of IGFBP3 promotes tumor metastasis in NPC, which makes it a potential therapeutic target.

Moon SH, Cho YS, Son YI, et al.
Value of (18)F-FDG heterogeneity for discerning metastatic from benign lymph nodes in nasopharyngeal carcinoma patients with suspected recurrence.
Br J Radiol. 2016; 89(1067):20160109 [PubMed] Article available free on PMC after 01/11/2017 Related Publications
OBJECTIVE: This study investigated the value of fluorine-18 fludeoxyglucose ((18)F-FDG) heterogeneity as an indicator of metastatic lymph nodes (LNs) in patients with nasopharyngeal carcinoma (NPC). We further assessed whether addition of this parameter improves diagnostic performance beyond that provided by maximum standardized uptake value (SUVmax).
METHODS: We analyzed 74 LNs that were suspicious for metastasis. These LNs were measured for coefficient of variation (CV) of (18)F-FDG uptake, which was used as a parameter for (18)F-FDG heterogeneity.
RESULTS: Multivariate logistic regression analyses revealed that a high CV (hazard ratio, 20.97; 95% confidence interval, 2.26-194.62; p = 0.007) was an independent predictor of metastatic LNs. However, receiver-operating characteristic curve analysis (p = 0.278) and net reclassification (p = 0.539) were unable to show improved diagnostic performance by addition of CV to SUVmax.
CONCLUSION: High CV of (18)F-FDG uptake is an independent risk factor for metastatic LNs in patients with NPC displaying suspicious LNs following treatment. Advances in knowledge: Heterogeneity of (18)F-FDG uptake has a potential as a biomarker of metastatic LNs.

Cui Q, Zuo XY, Lian YF, et al.
Association between XRCC3 Thr241Met polymorphism and nasopharyngeal carcinoma risk: evidence from a large-scale case-control study and a meta-analysis.
Tumour Biol. 2016; 37(11):14825-14830 [PubMed] Related Publications
The X-ray repair cross-complementing group 3 (XRCC3) Thr241Met polymorphism (rs861539, C > T) has drawn wide attentions as its association with cancer risk and its involvement in DNA repair. Several studies have attempted to link rs861539 to nasopharyngeal cancer (NPC) risk; however, the sample sizes of these studies are small and the results are controversial. To investigate the relationship of rs861539 and NPC susceptibility, we conducted a large-scale case-control study involving 4001 NPC cases and 2967 controls of southern Chinese. Logistic regression analysis revealed significant association for rs861539 and NPC risk under the recessive model (TT vs. CT + CC) with adjustment of age and gender (odds ratio, OR = 2.72; 95 % CI 1.10-6.72; P = 0.03). Further, meta-analysis involving 4457 NPC cases and 4132 controls from four studies showed consistent association of TT carriers and NPC risk (OR = 3.12; 95 % CI 1.58-6.13; P = 0.001). Taken together, our findings based on large-scale sample size suggested rs861539 at XRCC3 to be associated with NPC risk through recessive model.

Jiang C, Zhou L, Wang H, et al.
Axl Is a Potential Cancer Prognostic Marker for the Migration and Invasion of Nasopharyngeal Carcinoma.
Adv Clin Exp Med. 2016 May-Jun; 25(3):531-7 [PubMed] Related Publications
BACKGROUND: The Axl receptor tyrosine kinase has been demonstrated to be elevated and activated in many human cancers including liver, lung, breast, and pancreatic cancer. Its high expression has been considered as a cancer biomarker for predicting poor prognosis and increased invasiveness/metastasis.
OBJECTIVES: The aim of the study was to investigate the clinical significance of Axl in nasopharyngeal carcinoma (NPC) and its role in cell migration and invasion.
MATERIAL AND METHODS: We detected Axl expression in 86 collected NPC tissues and 20 collected normal nasopharyngeal epithelial tissues using quantitative reverse transcription polymerase chain reaction (qRT-PCR) and immunohistochemical staining. Axl was knocked down by a specific shRNA in NPC cell lines, 5-8F and 6-10B. Transwell assays were used to determine NPC cell migration and invasion.
RESULTS: The expressions of Axl mRNA and protein in NPC tissues were significantly higher than those in normal nasopharyngeal epithelial tissues (p < 0.05, respectively). The positive expression of Axl was significantly correlated with distant metastasis and high TNM stage in NPC (p < 0.05, respectively). Furthermore, Axl positive expression was correlated with a worse overall survival of NPC patients (p < 0.05). Multivariate Cox repression analysis indicated that Axl was an independent factor for predicting overall survival of NPC patients (p < 0.05). In vitro studies found that Axl knockdown significantly reduced the number of migrated and invaded 5-8F and 6-10B cells (p < 0.05, respectively).
CONCLUSIONS: The positive expression of Axl is correlated with the poor clinicopathological features in NPC. Furthermore, Axl is an independent prognostic marker for predicting overall survival of NPC patients. Functionally, Axl may facilitate tumour progression by promoting NPC cell migration and invasion.

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